Mattay Govind S, Mittl Gregory S, Zafar Hanna M, Cook Tessa S
Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
J Am Coll Radiol. 2020 Dec;17(12):1676-1683. doi: 10.1016/j.jacr.2020.05.014. Epub 2020 Jun 21.
Pennsylvania Act 112 requires diagnostic imaging facilities to directly notify outpatients about significant imaging abnormalities that require follow-up care within 3 months. The effects of Act 112 on patient care are unclear. We sought to characterize follow-up discussions and care received by outpatients with significant imaging abnormalities as defined by Act 112.
We evaluated findings flagged for patient notification under Act 112 at our institution over a 1-month period. We analyzed findings for radiologic reporting, follow-up discussions between patients and ordering providers, and follow-up medical care provided.
Follow-up discussions were documented for 87% of findings (n = 205 of 235) and occurred on average 6.0 days after imaging examinations were performed. Follow-up discussions directly attributable to the Act 112 letter occurred in 0.4% of findings. Follow-up care was provided for 74% of findings on average 31.3 days after imaging examinations were performed. Provider-initiated follow-up discussions occurred earlier and were associated with shorter time to follow-up care when compared with patient-initiated discussions. Direct contact of ordering provider by interpreting radiologist was a significant predictor of occurrence of follow-up discussions and length of time to follow-up care.
Act 112 had a small impact at our institution on improving completed follow-up for abnormal imaging findings. Our results also imply that health systems should encourage timeliness of patient-provider discussions of abnormal imaging findings and facilitate direct radiologist communication with ordering providers. Future studies should evaluate the impact of Act 112 in different practice settings to understand its broader impact on follow-up care.
